| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH BENEFIT SOLUTIONS, LLC | 18940 NORTH PIMA RD. STE. 210 SCOTTSDALE, AZ 85260 | SYMETRA LIFE INSURANCE COMPANY | — | $48K | $48K | 5.00% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP AGENCY ASSOCIATION LL | 216 S. 200 W. CEDAR CITY, UT 84720 | HARTFORD LIFE AND ACCIDENT | — | $6K | $6K | 1.23% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS | 465 S. 400 E. #300 SALT LAKE, UT 84111 | HARTFORD LIFE AND ACCIDENT | $5K | — | $5K | 1.06% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS | 465 S 400 E #300 SALT LAKE, UT 84111 | MARQUEE HEALTH, LLC | $9K | — | $9K | 6.29% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS | 465 S. 400 E. #300 SALT LAKE, UT 84111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | — | $10K | 10.00% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS | 465 S. 400 E. #300 SALT LAKE, UT 84111 | EYEMED | $5K | — | $5K | 7.22% |
| D'ANN DABELL4 | 1174 N. 2000 E. LAYTON, UT 84040 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | — | $2K | 18.85% |
| GBS BENEFITS INC4 Filed as: GBS BENEFITS INC. | 465 S. 400 E. SUITE 300 SALT LAKE CITY, UT 84111 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $797 | — | $797 | 6.07% |
| PAT MAURER4 | 2499 EAST 990 SOUTH SPANISH FORK, UT 84660 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $9 | — | $9 | 0.07% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS INC. | 465 S. 400 E. #300 SALT LAKE, UT 84111 | ALLSTATE WORKPLACE DIVISION | $1K | — | $1K | 8.86% |
| KAREN HARMER3 Filed as: KAREN L. HARMER | 2581 E. GOLDEN EYE DR. SANDY, UT 84093 | CONTINENTAL AMERICAN INSURANCE COMPANY | $82 | — | $82 | 0.85% |
| MARC A GROVE3 Filed as: MARC S. MICKELSEN | — | CONTINENTAL AMERICAN INSURANCE COMPANY | $76 | — | $76 | 0.79% |
| MAURICIO R PLATT3 Filed as: MAURICIO R. PLATT | — | CONTINENTAL AMERICAN INSURANCE COMPANY | $39 | — | $39 | 0.41% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS, INC. | 465 S. 400 E. SUITE 300 SALT LAKE CITY, UT 84111 | CONTINENTAL AMERICAN INSURANCE COMPANY | $37 | — | $37 | 0.39% |
| KAREN HARMER3 Filed as: KAREN L. HARMER | 2581 E. GOLDEN EYE DR. SANDY, UT 84093 | CONTINENTAL AMERICAN INSURANCE COMPANY | $31 | — | $31 | 0.32% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 E. SOUTH TEMMPLE #2300 SALT LAKE CITY, UT 84111 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24 | — | $24 | 0.25% |
| PATRICK M PECORARO3 Filed as: PATRICK M. PECORARO | 3276 EAST DEL VERDE SALT LAKE CITY, UT 84109 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24 | — | $24 | 0.25% |
| DAMON STREETMAN3 | 5894 WILDFLOW ER CT HIGHLAND, UT 84003 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24 | — | $24 | 0.25% |
| TIMOTHY B. CRAIG3 | 11829 S. PINNACLE ACRE COURT RIVERTON, UT 84065 | CONTINENTAL AMERICAN INSURANCE COMPANY | $15 | — | $15 | 0.16% |
| TYLER KOHLER3 | 1323 E. BENT PINE COVE DRAPER, UT 84020 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12 | — | $12 | 0.12% |
| MIKE C LUNDQUIST3 Filed as: MIKE C. LUNDQUIST | 8889 S. SILVER ST. ONCE WAY SANDY, UT 84093 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | — | $5 | 0.05% |
| BRENT W THOMPSON3 Filed as: BRENT W. THOMPSON | 435 E. 1070 S. OREM, UT 84097 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.03% |
| BARY BEVERLY AND ASSOCIATES, INC.3 | 11521 S. BLACK FOREST DR. SANDY, UT 84094 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.02% |
| NANCY LAPHAM3 Filed as: NANCY L HARMON | 3925 S. QUATAR ST. AURORA, CO 80018 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SELECTHEALTH EIN 87-0409820 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $777K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 965 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 965 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 5 | $98K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 884 | $98K |
| Vision | EYEMED | 1,508 | $69K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,034 | $507K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,034 | $507K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 903 | $964K |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 1,034 | $765K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,508 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.